Department of Paediatrics, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
Department of Paediatrics, University of Port Harcourt Teaching Hospital/ University of Port Harcourt, Port Harcourt, Nigeria.
West Afr J Med. 2021 Apr 23;38(4):307-312.
Human Immunodeficiency Virus (HIV) infects multiple tissues of the body, including the renal parenchyma, with HIV-associated Nephropathy (HIVAN) being the most common form of the HIV-related renal disease and an important cause of End Stage Renal Disease (ESRD) in HIV infected patients. There is paucity of studies on HIVAN among children with renal diseases, most studies on HIVAN focused on prevalence among HIV patients with vertical transmission being the commonest route. We undertook this study to determine the prevalence and impact of HIVAN among our renal patients and to highlight the new route of HIV transmission observed in these group of patients in Port Harcourt, Southern Nigeria.
The study was conducted among renal patients managed in the Paediatric department of the University of Port Harcourt Teaching Hospital from December 2016 to March 2019. The information on the HIVAN patients were stored and retrieved from the renal register where all cases of renal diseases were enrolled. The diagnosis of HIVAN was made based on presence of significant proteinuria (≥ 1+), with one or more of the following: abnormal microscopic examination of urinary sediments, rising serum creatinine, renal ultrasound finding of enlarged echogenic kidneys and histology finding of focal segmental glomerulosclerosis. The patient's sociodemographic data, clinical presentation, route of transmission of HIV, laboratory investigations, treatment, and clinical outcome were obtained and analysed using SPSS version 25.0.
There were 112 cases of renal diseases seen during the study period of which 10 (8.9%) had HIVAN. The HIVAN patients were aged between 4-17years. Four (40%) of these HIVAN cases had CKD of which 2 (20%) had ESRD. The route of transmission of HIV was vertical (mother-to-child) in 8 patients and via sexual route in two older male patients aged 17years who were homosexuals. Mortality rate among the HIVAN patients was 30%, with 2 (20%) lost to follow up.
There is a rising prevalence of HIVAN among paediatric patients with renal diseases in our environment, with homosexuality being a new route of HIV transmission observed in the older patients.
人类免疫缺陷病毒（HIV）感染身体的多个组织，包括肾实质，HIV 相关性肾病（HIVAN）是 HIV 相关肾脏疾病中最常见的形式，也是 HIV 感染患者终末期肾病（ESRD）的重要原因。在患有肾脏疾病的儿童中，HIVAN 的研究较少，大多数关于 HIVAN 的研究都集中在垂直传播的 HIV 患者中的患病率上，这是最常见的传播途径。我们进行这项研究是为了确定 HIVAN 在我们的肾脏患者中的流行率和影响，并强调在尼日利亚南部哈科特港的这些患者群体中观察到的 HIV 传播的新途径。
该研究是在 2016 年 12 月至 2019 年 3 月期间在波特·哈科特大学教学医院儿科病房管理的肾脏患者中进行的。从肾脏登记册中存储和检索有关 HIVAN 患者的信息，该登记册中所有肾脏疾病的病例都被登记。根据存在大量蛋白尿（≥1+），同时具有以下一种或多种情况，诊断为 HIVAN：尿沉渣异常显微镜检查、血清肌酐升高、肾脏超声检查发现肾脏回声增强和组织学检查发现局灶节段性肾小球硬化症。获得并使用 SPSS 版本 25.0 分析患者的社会人口统计学数据、临床表现、HIV 传播途径、实验室检查、治疗和临床结果。
在研究期间，共发现 112 例肾脏疾病，其中 10 例（8.9%）患有 HIVAN。HIVAN 患者的年龄在 4-17 岁之间。其中 4 例（40%）患有 CKD，其中 2 例（20%）患有 ESRD。HIV 的传播途径是垂直（母婴）传播，在 2 名年龄较大的男性同性恋患者中通过性途径传播。HIVAN 患者的死亡率为 30%，其中 2 例（20%）失访。
在我们的环境中，患有肾脏疾病的儿科患者中 HIVAN 的患病率呈上升趋势，在年龄较大的患者中观察到同性恋是 HIV 传播的新途径。
